EVALUATION OF PRAZOSIN THERAPY AT PRIMARY HEALTH CARE LEVEL AND CLINICAL PROFILE AND OUTCOME OF SCORPION ENVENOMATION IN A RURAL MEDICAL COLLEGE
Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 1
Abstract
Background:Scorpion sting is a life threatening pediatric medical emergency and major public health problem. Objective:The main objective of this study is to evaluate whether the Prazosin therapy was given or not for scorpion envenomation in children at Primary Health Care level and to study the clinical profile, complications and outcome of the scorpion envenomation in children. Methods: This prospective descriptive study was done at Government Dharmapuri Medical College Hospital, Tamilnadu, between Jan’2013 and Dec’2016. The children who were admitted with clinical features suggestive of scorpion sting were analyzed. Results:During the study period, 262 children were admitted with clinical features suggestive of Scorpion Envenomation. 57% of children were belongs to 1 to 6 years of age group. 76% of children were referred from PHC and Government Hospitals. Before referring to tertiary level centre analgesics, antihistaminic and steroid were given in 53% of children, whereas 3% children only received prazosin before referral. The common clinical features noted were diaphoresis (74%), pain at bite site (70%), excessive salivation (62%), drowsiness (52%) and vomiting (42%). The common clinical signs were cold peripheries (76%), shock (71%), tachycardia (65%), hypertension (51%), tachypnea (32%) and priapism (21%). Peripheral circulatory failure (76%), pulmonary edema (27%), myocarditis (17%) and cardiac failure (14%) were the most important complications encountered. 77% of children received 1st dose of prazosin within 8 hours. Complications like, pulmonary edema, cardiac failure and hypotensive shock were common who came after 8 hours of scorpion sting. 76% of children needed prazosin. Doputamine (36%), adrenaline (5%), Oxygen through Jackson-Rees Circuit (27%) and non invasive ventilation (10%) were needed to treat the complications. Conclusion: Only 3% of the children were received prazosin before referral. The common clinical features of scorpion envenomation were autonomic storm followed by pulmonary edema. The morbidity and mortality of the scorpion envenomation is directly related to the sting-Prazosin interval.Doputamine, Oxygen through Jackson-Rees Circuit, Non-invasive ventilation were life saving for complications due to scorpion envenomation. There is an urgent need to create awareness to primary healthcare doctors about prazosin for scorpion envenomation
Authors and Affiliations
Balaji J, Punitha P, Sasikala K, Ramesh Babu B, Kumaravel K. S
Keywords
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